| NPI | 1609075639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIBHA G GAUTAM Owner 860-442-5976 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: CT 021848) |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2007-07-11 |